Framework for planning CTAC services 2. Patients 3. Delivery - - PowerPoint PPT Presentation
Framework for planning CTAC services 2. Patients 3. Delivery models 4. Services 1. Planning provided 5. Workforce 7. IT systems #ctacQI 5. Workforce Jenny Wilson Assistant Director of Quality Improvement, NHS Ayrshire & Arran
models
provided
WORKFORCE
Principles for Integrated Community Teams Principles for the Workforce
Primary care has professional and expert management, leadership and organisational support Small self-organising, geographical-based teams. Health and care professionals working in partnership A senior clinician, capable of making decisions about the correct course of action, is available to patients as early in the process as possible Primary care is delivered by a multidisciplinary team in which full use is made of all the team members, and the form of the clinical encounter is tailored to the need of the patient Primary care practitioners have immediate access to common diagnostics, guided by clinical eligibility criteria Nuffield Trust and Kings fund Neighbourhood care principles House of Care Canterbury Health System
Nuka
Professional autonomy
Principles for Integrated Community Teams Principles for the People
Building relationships with people to make informed decisions about their
and independence with active involvement of family, neighbours and the wider community, where appropriate Putting the person at the centre of holistic care Relationships between the customer-
be fostered and supported Emphasis on wellness of the whole person, family and community including physical, mental, emotional, and spiritual wellness. Together with the customer-owner as an active partner Hub of the system is the family Services should enable people to take more responsibility for their own health and wellbeing People should stay well in their own homes and communities as far as possible Engaged, informed individuals and carers Organisational and clinical processes structured around the person Care for frail people with multi- morbidity is tailored to the individual needs of patients in this group, in particular people in residential or nursing homes Where possible, patients are supported to identify their own goals and manage their own condition and care Interests of the customer-owner drive the system to determine what we do and how we do it
Principles for Integrated Community Teams Principles for the System
Everyone, including support functions, enabling person- centred care at the point of delivery. Locations that are convenient for the customer-
customer-owner Access is optimised and waiting times are limited International whole system design to maximize coordination and minimize duplication Outcome and process measures to continuously evaluate and improve Not complicated but simple and easy to use Services are financially sustainable and viable Population-based systems and services When complex care is required it should be timely and appropriate Patients can benefit from access to primary care advice and support that is underpinned by systematic use of the latest electronic communications technology Commissioning Patients have the minimum number of separate visits and consultations that are necessary, with access to specialist advice in appropriate locations Patients are offered continuity of relationship where this is important, and access at the right time when it is required There is a single electronic patient record that is accessible by relevant organisations and can be read and, perhaps in future added to, by the patient Primary care organisations make information about the quality and outcomes of care publicly available in real-time
Enabling Access Leadership Senior Clinician Coproduced Professional Autonomy Person - centred Integrated teams Population Based
Key points
concerns about the workforce issues were raised in the majority of our interviews.
Workforce planning
required for CTAC delivery.
should be considered.
across the system.
approached by different areas.
Right skill mix
need to be part of the skill mix. Many areas are considering a mixture of nursing bands and healthcare assistants to staff the services.
patients holistically and therefore potentially de-skilling nurses. On the other hand, there were also concerns about not having the ‘right skills’ for CTAC services.
pathway, which would make recruitment for these posts more attractive.
Resources
Midwifery and Health Professions (NMaHP) roles papers here.
We will all be fighting for the same people
Recruitment issues, not enough staff to go round, taking staff from every area (this will result in) major workforce issues We are already doing stuff that is expected
necessarily prove qualifications CTAC need to be staffed by people competent to fulfil the role (competency based) rather than role based (task orientated) so staff can holistically treat the patient rather than just fulfil tasks. CTAC will provide a better career pathway for current treatment room nurses with better
training.
Key points
Clinical governance
and appropriate clinical decision making should be ensured.
Change management / staff engagement
may be required. Some of the already established CTAC services mentioned that from conception of the idea to fruition took much longer than expected and generated more opposition than they anticipated.
unintended consequences (for example early retirement). These are some examples of what could be done to ease the transition:
the management of chronic diseases. However, some expressed concerns that GPs may reduce the staff employed within practices.
Transfer of staff
Health Board. This can be challenging both technically and emotionally. However, TUPE could also bring new opportunities, including career development opportunities.
Examples
See here for examples of what people are doing to manage change.
* TUPE refers to the "Transfer of Undertakings (Protection of Employment) Regulations 2006”
Vital to provide training and helpline and re-training if necessary. Convince them what they are going to do is not going to take up any more time My job will be completely taken away if CTAC services are running How do you get the balance: robust central governance and clarity of service provision but with a level of devolved responsibility? People are moving on because of uncertainty. Nobody knows what’s happening and that breeds unrest Team is very visible so people are used to seeing them and communication is open